When I began my counter fraud career almost 30 years ago in the Department for Work and Pensions, I quickly realised how innovative fraudsters were in their pursuit of a financial gain.

Since then, technology has changed the way we all live and work, and unconstrained from organisational processes and policies, fraudsters have continued to innovate, embracing technology to commit financial crime against the public sector, including the NHS.

As a result, fraud is now the most prevalent crime in England and Wales, and the NHS Counter Fraud Authority (NHSCFA) estimate that the NHS is vulnerable to £1.316 billion worth of fraud each year.

So as the Head of Counter Fraud for SAFE – Security and Fraud Experts, when I heard about the Workforce Integrity and System Efficiency (WISE) Project, I had to be involved.

SAFE is a Dorset HealthCare hosted provider of counter fraud and security management services to the public sector, including the NHS, Independent Healthcare Providers, and Local Authorities.

The WISE Project is a collaborative initiative led by the NHSCFA in partnership with several NHS organisations across the South of England, including Dorset HealthCare and University Hospitals Dorset in phase 1, and Dorset County Hospital in phase 2. Participation in the project puts the NHS in Dorset at the cutting edge of fraud detection and prevention.

The WISE Project is a proactive, data-driven exercise designed to detect and prevent fraud within NHS workforce and agency operations through the innovative deployment of machine learning. It involves a controlled data share that enables authorised NHSCFA analysts to access relevant, localised datasets.

This cross-organisational approach, supported by advanced data science techniques, aims to identify patterns associated with three specific and substantiated fraud risks:

  • Working while on sick leave,
  • Impersonation (Imposters),
  • Dual working / multiple employment.

Project WISE will offer several benefits, including:

  1. Adaptive Defence: Helping us stay ahead of rapidly changing fraud techniques by anticipating new threats rather than just reacting to old ones.
  2. Improved Detection: Enabling more accurate and faster identification of suspicious patterns that human analysts might miss.
  3. Efficiency: Deploying innovative tools such as machine learning, will help automate fraud detection processes, reducing manual workload and costs while increasing response speed.
  4. Public Trust: Deploying cutting-edge anti-fraud measures reassure the public that the NHS is protecting vital resources from financial crime to ensure that we can continue to provide world leading NHS funded healthcare.
  5. Regulatory Compliance: Proportionate and effective fraud detection processes support compliance with contractual and regulatory requirements, including Government Functional Standard 013: Counter Fraud, and section 199 of the Economic Crime and Corporate Transparency Act 2023.

In short, innovative initiatives such as the WISE Project, empower the NHS to be proactive, efficient, and resilient against ever-changing fraud threats, helping us to protect valuable resources and deliver world class patient care.

Andy Knight – Head of Counter Fraud for SAFE – Security and Fraud Experts

08/10/2025